Competency-based Medical Curriculum Research Articles

Implementation status of the nationally harmonized competency-based, integrated, modular medical curriculum in Ethiopia: opportunities and challenges

BackgroundWell-designed curriculums are crucial for quality education. This study aimed to assess the implementation status of a harmonized competency-based medical curriculum (CBMC) in Ethiopia, as well as identify the associated challenges and benefits.MethodsA mixed-method approach was used. Data collection took place from September 1, 2023, to October 15, 2023. Eleven medical schools were randomly selected from a list of 28 public medical schools in Ethiopia. Participants were purposively chosen from selected medical schools using a controlled sampling method. A total of 121 participants took part in the survey. Interviews and focus group discussions were conducted with key informants to complement the quantitative findings. Descriptive statistics, such as frequencies and percentages, were used to summarize the quantitative survey responses. Thematic content analysis was used to analyze the qualitative data.ResultsThe implementation of a CBMC in Ethiopian public universities faces various challenges and provides opportunities. Around 22% of respondents mentioned that the whole group session (WGS) had never been implemented in their school. Regarding community-based learning (CBL), 64.6% of respondents noted that it was intermittently implemented in their institution. Only 32% of respondents considered students’ clinical exposure during preclerkship years to be reasonable. Interestingly, approximately 73% of respondents stated that problem-based learning (PBL) activities were regularly conducted in their school. Around 68% of respondents believed that competency-based assessment methods were moderately utilized. While many participants perceive the curriculum as having positive content alignment and structure with intended learning outcomes, challenges related to practical sessions, resource limitations, and uneven access to training opportunities persist. Resource constraints are a prominent challenge. The opportunities identified include early clinical exposure and enhanced communication skills.ConclusionsThis survey highlights the need for ongoing curriculum evaluation and fine-tuning to ensure its success.

Evaluating the Impact of Faculty Development Programs in Generating Self-Efficacy and Competency Among Medical Teachers in India.

Background Maintaining the quality of teaching across India is a challenge. Teachers are equally responsible for patient care and administration. The importance of training medical teachers under the various faculty development programs (FDPs) is well accepted. A mechanism to evaluate the competencies acquired by medical teachers after attending FDPs becomes equally important. In the present study, we evaluate the impact of the various FDPs on medical teachers. Methodology A cross-sectional study was conducted for one year among 50 medical teachers attending FDPs. Ethical clearance was taken from the Institutional Ethical Committee.For quantitative data collection, the questionnaire was validated by the Scientific Approval Committee of the Institute. The study questionnaire was filled in by the participants just before and three months after attending FDPs. For qualitative data collection, in-depth Interviews (IDIs) using the Kirkpatrick model of learning evaluation were conducted. Descriptive statistics were presented as frequencies and percentages. The thematic areas of self-efficacy and teaching competency before and after FDPs were tested using the chi-square test. P-values <0.05 were considered significant. Results There was a significant increase in self-efficacy (300 vs. 426,p= <0.0001) and teaching competency (456 vs. 608, p = <0.0001) in the domains of teaching difficult students and motivating students for innovative projects. Improvement in communication skills and ability to engage the students were noteworthy in teaching competency. IDIs revealed that FDPs are essential for the efficient delivery of the competency-based medical curriculum. Conclusions FDPs play a key role in bringing about significant improvement in generating self-efficacy and teaching competencies among medical teachers. FDPs may beincorporated into the postgraduate medical curriculum itself.

Comparative Curriculum Analysis for Preclinical Medical Education: Between Cohorts and Between Instructors

Prior to Fall 2023, the two medical campuses of the University of Minnesota, have hadtwo different curricula. Though the Duluth campus has delivered an integrative, systems-based curriculum, the Twin Cities campus has delivered a discipline-basedcurriculum. Outcome measures (1) pass rate and scores on Step 1 board exams, 2)graduation data and 3) match success) demonstrate strong comparability betweenthe two curricula. Starting in September 2020, another opportunity for comparisonoccurred; a single instructor taught pulmonary content to both the Duluth (Fall 2020)and Twin Cities (Spring 2020) cohorts and another single instructor taughtcardiovascular content to both the Duluth (Fall 2020) and Twin Cities (Spring 2021)cohorts. Both cohorts were given and assessed on the same set of learning objectives;leading us to ask the following question: Does the structure of the preclinical curriculum(systems vs discipline-based) impact the learning outcomes of physiology, particularlythe ability to integrate material? We compared the two cohorts by comparing acommon set of exam questions assessing cardiovascular and pulmonary physiology. Wemeasured question performance by question diffculty index (expressed as a percent)and question cognitive level by determining the Bloom’s Taxonomy Cognitive level(knowledge, comprehension, application, analysis, synthesis and evaluation). We foundno differences between the cohorts in question diffculty as a function of content typeor levels of Bloom’s taxonomy. We conclude that there was no difference in overallperformance of the Duluth and Twin Cities cohorts despite receiving different curricularapproaches. However, we had an unexpected finding from the analytics; thecardiovascular items were significantly more diffcult than the pulmonary items. Thisresult has implications for a team-taught medical school curriculum given the source ofthe difference could be the difference in teaching style, the difference in content or thedifference in item writing. We therefore are beginning an exploration of the differencein item analysis and possible impacts on student evaluations. The important of this lineof inquiry is that first, consistency in item diffculty potentially impacts a competencybased medical curriculum and second, how students perceive differences in itemdiffculty has the potential to affects instructor evaluations and therefore promotionand tenure. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Progressive muscle relaxation in pandemic times: bolstering medical student resilience through IPRMP and Gagne's model.

Medical education, already demanding, has been further strained by the COVID-19 pandemic's challenges and the shift to distance learning. This context underscores the need for effective stress reduction techniques in competency-based medical curricula (CBMC). We assessed the feasibility and benefits of integrating a Progressive Muscle Relaxation (PMR) module-a known effective stress-reducing technique-into a time-restricted CBMC, particularly given such modules often find placement as elective rather than mandatory. Adapting Gagne's nine events of instruction, a 2-h PMR program was designed and implemented during the pandemic. Twenty participants were engaged on a first-come, first-served basis, ensuring adherence to social distancing measures. Feedback was continuously gathered, leading to two post-program focus group sessions. Qualitative data underwent thematic analysis following Braun and Clarke's approach, with study quality maintained by the Standards for Reporting Qualitative Research (SRQR). To gauge adaptability, we aligned the program with various learning outcomes frameworks and explored its fit within CBMC using Bourdieu's Theory of Practice. The pilot PMR program was well-received and effectively incorporated into our CBMC. Our analysis revealed five central themes tied to PMR's impact: Self-control, Self-realization, Liberation, Awareness, and Interpersonal relationships. Feedback indicated the program's capacity to mitigate stress during the pandemic. The SRQR confirmed the study's alignment with qualitative research standards. Further, the PMR program's contents resonated with principal domains of learning outcomes, and its integration into CBMC was supported by Bourdieu's Theory. These observations led us to propose the Integrative Psychological Resilience Model in Medical Practice (IPRMP), a model that captures the intricate interplay between the identified psychological constructs. This research showcases an innovative, theory-guided approach to embed a wellbeing program within CBMC, accentuating PMR's role in fostering resilience among medical students. Our PMR model offers a feasible, cost-effective strategy suitable for global adoption in medical institutions. By instilling resilience and advanced stress-management techniques, PMR ensures that upcoming healthcare professionals are better equipped to manage crises like pandemics efficiently.

Competency-Based Medical Curriculum: A Resurgent Paradigm for Medical and Dental Graduates

Present society is characterized by its growing complexity, dynamics and knowledge intensity, which requires professionals who are able to face new situations and problems confidently and expertly. Education faces the problem that knowledge acquisition does not necessarily mean the successful application of the same knowledge. In case of academic professionals, they should possess a broad and profound domain-specific knowledge and skills, the capability to acquire knowledge expeditiously and know-how where and when needed. Learning in a professional context has, therefore, become more important and general academic education is becoming more professional oriented. Medical education is changing to meet the demands of ever evolving health care system. One of these changes is the development and implementation of competency-based medical education (CBME). Competency-based learning and training is an approach to teaching and learning more often used in learning concrete skills than abstract learning. It differs from other non-related approaches in that the unit of learning is extremely fine-grained. Rather than a course or a module, every individual skill or learning outcome (known as a competency) is one single unit. Learners work on one competency at a time, which is likely a small component of a larger learning goal. The student is evaluated on the individual competency and can only move on to other competencies after they have mastered the current skill being learned. After that, higher or more complex competencies are learned to a degree of mastery and are isolated from other topics. Another common component of competency-based learning is the ability to skip learning modules entirely if the learner can demonstrate mastery. This can be determined through prior learning assessment or formative testing. This article pertaining to the discipline of medical education gives a broad overview and elaborates on this emerging competency based medical education approach and its related concepts.

Flipped Classroom for Undergraduate Medical Students in India: Are we ready for it?

The teaching-learning environment has undergone a paradigm shift with the recent implementation of a Competency-Based Medical Curriculum in India. Despite this, the concept of flipped classrooms for medical students is still in its infancy in our country. We conducted an experimental randomized crossover study to find if a flipped teaching model improves learning for first-year medical undergraduate students. Students' perceptions of this novel method were also obtained and analyzed. In the first period (first part of the study), one group of students underwent the Flipped Model Teaching (Flipped Teaching Group), and the second group (Traditional Teaching Group) was taught by the conventional method. A crossover was done with a second topic in the second period. A written test was conducted at the end of each period. Student feedback was also obtained. There was no statistically significant difference in students' performance on comparing traditional and flipped teaching methods. Reasons for this could be the level of the learner, prior exposure to active learning strategies, learner readiness/motivation for active learning, and timing of the study. Out of the participants 80% of students preferred the flipped model classroom teaching, especially the interactive discussion, and expressed their desire for more frequent similar learning activities. We conclude that there was no difference in marks obtained by students in the two groups, yet they preferred the flipped classroom method, which indicates that it is feasible to adopt this method in the Indian medical undergraduate classroom.

Competency-based medical curriculum: Exploring the preclinical medical teachers' pedagogical and technical readiness levels.

Background The medical curriculum for undergraduates was revised by the Medical Council of India in 2019, after 21 years. We did this study to determine teachers' pedagogical and technical readiness to implement the competency-based curriculum in medical colleges and determine factors that affect readiness, from their perspective. Methods We conducted a cross-sectional survey in the form of an online questionnaire. The qualitative data were coded numerically and were analysed using frequencies and proportions. Pearson Chi-square test was used to study the association among variables. Results The majority (85%) of respondents had attended a curriculum implementation training programme; 62.2% with experience <5 years, 56.1% with experience 5-10 years and a minority of 13.3% with >10 years' experience were ready to a 'great extent' to implement the new curriculum; 54.1% agreed to re-frame lectures and 64.9% possessed technological skills to suit the needs of a competency-based curriculum. About 77% agreed that it will provide a rich learning environment, inspire self-directed learning while 52% believed it will promote scientific thinking and provide better learning outcomes in the long run. Conclusion Medical teachers had a positive attitude towards implementation of the new curriculum. However, numerous factors such as low teacher-student ratio, textbooks designed according to the traditional curriculum, limited teachers' training and cumbersome paperwork may hinder its successful implementation. Updation of teachers' knowledge and skills through seminars/workshops is recommended to facilitate delivery of the new curriculum. Like any other ongoing reforms in medical education, competency-based curriculum is a work in process.

Impact of New Competency-Based Medical Curriculum on the Educational Environment of Medical Students in a Medical College in Central Kerala

Background: Competency-based medical education (CBME) for graduate medical students was introduced by National Medical Commission from the 2019 batch. This paper seeks to estimate the impact of CBME on the educational environment of medical students and to compare the university examination outcomes after the introduction of CBME with the antecedent non-CBME batch. Methods: A cross-sectional study was carried out among all the students (197) of the CBME and preceding non-CBME batch of a medical college in central Kerala. The educational environment was collected in the online platform with a standard questionnaire, Dundee Ready Education Environmental Measure (DREEM questionnaire) in 5 domains: perception of learning, perception of teachers, student’s academic self-perception (ASP), perceptions of atmosphere, and social self-perception (SSP). Results: The overall DREEM score was found to be significantly higher at 122.7 in the CBME batch compared to 112.8 in the non-CBME batch (P &lt; .002). The individual mean domain scores of “perceptions of learning” was the highest at 30.39 ± 5.17 followed by “student’s perception of atmosphere” with a mean score of 29.53. Perception of learning, ASP, perception of atmosphere, and SSP were statistically significantly higher in CBME (2019) batch. The proportion of failures was significantly higher in the non-CBME batch, and among those with distinction, 3 out of 4 students were from CBME batch. The DREEM score was also significantly correlated with the university marks score. Conclusion: It appears that the CBME batch is performing better than the previous non-CBME batch and also has a better educational environment, though larger studies are necessary to further examine this phenomenon.

Use of high-fidelity simulator for teaching cardiovascular physiology principles to the 1st year undergraduate medical students

Objectives: Medical education has undergone significant changes all over the world and patient safety is one of the main reasons for the changes. The new competency-based medical curriculum in India also emphasises early clinical exposure along with the acquisition of competent and verifiable skills. The objective of this study was as follows: (1) to introduce the 1st year medical students to simulation-based learning (SBL) to develop their knowledge, skills, and communication and meet the desired learning objectives without exposing subjects to any harm and gain valuable immersive experience that felt real and (2) to obtain students feedback about SBL in learning applied aspects of physiology. Materials and Methods: The study was approved by the Institutional Ethical Committee. A total of 132 1st year medical students were divided into six batches and each batch was exposed to a pre-test, simulation exercise, a debriefing session, post-test, and feedback. Descriptive analysis of the data was done and values were expressed as mean and standard deviation. The McNemar test was used to study the effectiveness of SBL. Results: The average pre-test and post-test correct responses were 64.6% and 77.5%, respectively. This difference was found to be highly significant with P &lt; 0.001. The mean pre-test score and post-test scores were 6.46 ± 1.39 and 7.75 ± 1.52, respectively, with P &lt; 0.001. P &lt; 0.05 was considered statistically significant. Positive feedback was received from the students with 86.8% of them strongly agreeing to the incorporation of simulation-based activities in the curriculum. About 76.7% strongly agreed to a self-perceived increase in their decision-making, communication, and teamwork skills. Perception of the simulation as a realistic experience was perceived by 74.4% of the students. Conclusion: SBL is an effective tool for learning applied physiology and was viewed by the students with interest. It also enhanced their understanding of the pathophysiological basis of the clinical scenario.

Challenges in the Implementation of Competency-Based Medical Curriculum: Perspectives of Prospective Academicians.

Introduction The medical education system all over the world is witnessing a paradigm shift from traditional methods of teaching to competency-based medical education. With the current curricular change, teachers are supposed to play a catalyst role in terms of moderating the different frameworks of competency-based medical education (CBME). Following the implementation of the new curriculum in India (2019), the presentstudy aims to understand the challenges that medical teachers face in its implementation. Materials and methods This nationwide cross-sectional study was conducted among 297 teaching faculty representing 91 medical colleges across 20 states between February and July 2020.A self-validated structured questionnaire onthe views of the newly implemented competency-basedmedical curriculum was prepared, uploaded as a Google form link, and circulated to medical teachers through an electronic platform across the country The faculty responses were exported and analyzed using Microsoft Excel. Results Around 77.4% opined that making incremental changes to the old curriculum would have been better than the overhaul revision, and 85.6% have opined that input from more faculty must have been taken before implementing the new curriculum. Around 80% felt that the pace at which faculty are getting trained in the nodal/regional center is not adequate, and 75% of them believed that the faculty members are not adequate for preparatory work for CBME implementation. About 74.7% opined that framing specific learning objectives(SLOs) for all competencies is time-consuming. Conclusion It is the need of the hour for the curriculum to incorporate a systematic feedback mechanism built into the system. Despite the fact that many of the suggested changes are progressive, given the time and resource constraints, this can only be accomplished through the concerted and combined efforts of all those involved in medical education.

Redefining the role of a learner in the competency-based medical curriculum.

Redefining the role of a learner in the competency-based medical curriculum.

Self-directed Learning Theory to Practice: A Footstep towards the Path of being a Life-long Learne.

The traditional education strategy is insufficient to meet the demands of dynamically changing medical science and the fast-growing medical field. The present Competency-Based Medical Curriculum for medical undergraduates in India emphasizes acquisition of a set of competencies for self-directed learning (SDL) through an explicit approach and dedicated teaching hours in the disciplines which gives the opportunity to develop skills for developing lifelong learners. Self-directed learning cuts across all domains of learning and has a significant potential in shaping transformational learning experiences. The concepts of SDL are based on adult learning principles and experiential learning fostering skills for lifelong learning. In view of the paradigm changes in the new curriculum, it is imperative to understand the basic concepts and the methods for effective practice of SDL in the new curriculum. Faculty development for SDL, ensuring the availability of resources, harnessing the power of information technology, and integrating cognitive and affective assessment strategies enhance the effectiveness of SDL. We revisited the literature, and critically summarize our views on the theory-to-practice concepts of self-directed learning. The article discusses the basic concept of SDL, implementation strategies, and evaluation of self-directed learning.

Competency Based Medical Education: An Overview and Application in Pathology

Introduction: The Competency-based curriculum is the turning point in medical education and holds much potential in the current trends of medical transformation in India. It provides an outcome-based approach with the integration of knowledge, skills, attitude, values, and ethics. In comparison to the older curriculum, it differs in clarity, cohesion and has a comprehensive approach.&#x0D; Methods: The study aims to discuss and evaluate in detail the process and establishment of a competency-based medical curriculum in the pathology department and highlights the ups and downs of the experience. It was set up following the guidelines provided by NMC under competency-based undergraduate curriculum for the Indian medical graduate, state university guidelines references from the internet, and peer review from other institutions.&#x0D; Results: The new curriculum has bought many positive changes and requires a radical change in the approach of faculty, institution, and students.&#x0D; Discussion: General preparedness, outgoing and flexible attitude, consistency, and long-term commitment to a transformation from being a facilitator will be the prime needs to make the new “Indian medical graduate.”

Virtual microscopy as a teaching–learning tool for histology in a competency-based medical curriculum

BackgroundHistology forms an important component of first-year medical education. Unfortunately, it is limited to the practical laboratory due to the need for a microscope and good quality slides. Virtual microscopy is a recent advancement, which uses computers as an alternative to microscopes. The aim of the study was to compare virtual microscopy (VM)-based practical classes with traditional microscopy (TM)-based practical classes for two cohorts of first-year medical students, by comparing learning achieved using two different test scores as well as a qualitative assessment of student and faculty perspectives regarding the feasibility and usefulness of VM. MethodsEach cohort of students was divided into two equal batches and each batch underwent eight histology modules of which, four utilised traditional microscopes and four utilised virtual microscopes. Quantitative analysis was performed using a theory test (which assessed preparation, theory knowledge and understanding) as well as a spotter test (which assessed identification skills, reasoning, and recall). Qualitative analysis was performed using a structured questionnaire and focus group discussions. ResultsModules using VM were better when compared with those using TM, showing statistically significant and better grades. Qualitative analysis performed, yielded important information as to how this technology can serve as a good adjunct to traditional histology classes in the competency-based curriculum by increasing student interest, enabling self-study, and reducing students dependence on the tutor. ConclusionsVM forms a good adjunct as well as a standalone modality of learning to TM, as it improves accessibility to slides and promotes self-learning.

THE COMPARISON OF DIFFERENT ASSESSMENT TECHNIQUES USED IN PHYSIOLOGY PRACTICAL ASSESSMENT

Background: A new competency-based medical undergraduate curriculum has been made by the National Medical Commission (NMC) initiating in 2019. Practical exercises which are application-oriented are recommended in this new curriculum among the Pre- and Para clinical subjects. In an attempt to improve the physiology practical assessment in our institution, and following the new competency-based medical curriculum, the spotting and clinical-based question assessment methods were introduced along with the other conventional assessment procedures like Hematology Practical, Graph and charts, and Clinical Examination in the rst year of the medical curriculum. The purposeAims and Objectives: of the present study was to see the relationship between the scores obtained by medical students in different methods during various evaluations in the rst year of medical college and to explore gender differences in student scores among the varied assessment program used in Physiology practical assessment. A cross-sectional study was conducted on 125 undergraduate medical students at the DepartmentMaterials and Methods: of Physiology, Regional Institute of Medical Sciences, Imphal during the period between December 2021 to January 2022. Five different practical physiology assessment methods namely Hematology practical, Clinical examination, Graphs, and charts, spotting, and lastly clinical-based question assessment methods were used to determine the mean student scores. The data collected were entered into IBMStatistical Analysis: SPSS 26.0 version (IBM Inc. Armonk, NY, USA) and analysed using descriptive statistics. Statistical signicance was set at p-value&lt;0.05. Results: 125 students (male 72, female 53) in the age range of 18 – 23 years participated in the study. The mean score of Graphs and Charts marks was the highest while students (12.26) scored lowest in the Clinical based question assessment method (9.31). The female students scored signicantly higher marks in spotting and clinical-based questions. There was a signicant variation in the marks obtained in differentConclusion: assessment techniques. The gender differences in the average scores were not signicant at conventional methods like haematology practical, graphs and charts, and clinical examination

Perceptions of Medical Undergraduate Students on Curricular Changes in Anatomy: An Embedded Design Mixed Method Study.

Introduction: Implementation of competency-based medical education (CBME) offers challenges to the faculty and students. As a part of the new curriculum by the National Medical Council of India, we introduced certain teaching and assessment modifications in anatomy. There are few studies on the actual implementation of CBME. The current study aimed to assess the perceived usefulness of the teaching, learning, and assessment methodology (TLAM) based on written feedback from students.Methods: All the 147 first MBBS students of the batch who had undergone the new teaching learning methodology answered the questionnaire on usefulness of the various TLAMs on a 3-point Likert scale which was taken as quantitative data. They were also asked to pen down their opinions and suggestions about the TLAM which was thematically analysed and considered as qualitative data. Face and content validity was assessed prior to administration of the questionnaire. Descriptive statistics were used for quantitative variables. Qualitative data were analysed by thematic analysis.Results: 100% of the students found vertical integration and small group teaching as useful. Seminars and quizzes were reported as useful to extremely useful by 75.5% of the students. Self-directed learning and near-peer teaching was also appreciated well by 78% of students. In Embryology and Neuroanatomy, these active learning methods were not found to be useful as these topics were difficult to understand. Overall, the new TLAM introduced as per the new medical curriculum was found useful for the majority of students.Conclusion: This study provides valuable insights on the teaching, learning, and assessment methods as formulated by the competency-based medical curriculum. Though active learning methods are the integral principles of andragogy, the concepts which are difficult to understand need to be taught using the traditional teaching methodology.

Establishing New Curriculum of Pathology and its Challenges at a New Medical College

Background: A competency-based curriculum is the key highlight of medical transformation in India, which provides an outcome-based framework requiring the integration of knowledge, skills, and values, unlike an old curriculum that did not provide a cohesive and comprehensive outlook. Objectives: We aimed to discuss and evaluate in detail the process and setup of a new competency-based medical curriculum in the Department of Pathology and enlist the assets and challenges while doing the same. Methods: The new curriculum was set up as per the guidelines provided by the National Medical Council, along with assistance from state university guidelines, articles from the internet and discussions with other universities all over the country. Conclusions: As compared to the previous curriculum, the new curriculum introduces many positive changes and requires a revolutionary change in the outlook of institutions, faculty, and students. Prior preparedness, flexibility to adopt new changes, consistency and long-term commitment through the transition process from facilitators will go a long way in producing an excellent Indian medical graduate.

A multidimensional approach to new competency-based medical curriculum in physiology

A multidimensional approach to new competency-based medical curriculum in physiology

Exploring the learners' perspectives on competency-based medical education.

BACKGROUND:A novel innovation in medical education was initiated by the Medical Council of India after 21 years. Competency-based medical education (CBME) is an effective outcome-based strategy, which requires integration of knowledge, attitude, skills, values, and responsiveness. The aim was to assess the students’ perspectives on competency-based medical curriculum.MATERIALS AND METHODS:This cross-sectional descriptive study was conducted among 1st year MBBS students (2019–2020 batch). A validated questionnaire was administered through Google link among phase I medical students of various medical colleges across India by multistage sampling.RESULTS:A total of 987 students from 74 medical colleges in India responded. Nearly three-fourths opined that foundation course (FC), attitude ethics communication module, and early clinical exposure were necessary. Horizontal integration was more appreciated to vertical integration. Maintaining log books was perceived as time-consuming and cumbersome.CONCLUSION:The CBME when meticulously adopted will inspire student enthusiasm for learning. Few reforms such as curtailing the duration of FC, diffuse sessions on stress and time management, better synchronized vertical integration, and an exemplary implementation of adult learning techniques can be undertaken.

Cross-cultural adaptation of the EFFECT questionnaire into Brazilian Portuguese

Abstract: Introduction: Clinical teaching is based on a real work environment, in professional practice settings, such as health services and units, under the supervision of the preceptor. Providing medical teachers with an assessment of their teaching skills is a powerful tool for improving clinical learning for students in training. In this context, the EFFECT (Evaluation and Feedback for Effective Clinical Teaching) questionnaire was developed by Dutch researchers in 2012 for teacher evaluation, being validated based on the literature about medical teaching in the workplace and incorporates the skills of the Canadian competency-based medical curriculum. Objective: To translate and cross-culturally adapt into Brazilian Portuguese and to validate the EFFECT questionnaire for teacher evaluation by Medical students. Method: Cross-cultural adaptation with the following steps: initial translation of the English version, synthesis of translated versions, back-translation, creation of a consensual version in Brazilian Portuguese, with adaptation, review, and analysis of content validity by an expert committee, pre-test with retrospective clarification interview, and reliability analysis by factorial analysis and internal consistency test (Cronbach’s alpha coefficient). Result: In the translation and back-translation stages, the disagreements were related to the use of synonyms and none of the items were modified in terms of their understanding, but in terms of adaptation into the Brazilian context. The evaluation of the expert committee showed the versions maintained the semantic and idiomatic equivalences of the content. Eighty-nine students participated in the pre-test. The internal consistency of the EFFECT questionnaire in Brazilian Portuguese was excellent for all domains, with Cronbach’s alpha coefficient ranging from 0.82 to 0.94. Conclusion: The translated and adapted version of the EFFECT questionnaire into Brazilian Portuguese is equivalent to the original instrument and has evidence of high validity and reliability, being able to constitute a national tool to evaluate the efficiency of clinical medicine teaching.